Radiology Coding Alert

Separate selective and nonselective procedures with ease

Coding interventional procedures is one of the most demanding aspects of being a 36160. We’ve boiled down selective and nonselective to the basics to get you on the road to perfect claims every time.

1. Acquaint yourself with nonselective essentials. In nonselective procedures, the physician:

•  places a catheter directly into an artery or vein and stops

•  manipulates the catheter from another artery into the aorta and stops or

•  manipulates the catheter from another vein into the superior or inferior vena cava and stops.

Remember: You’re far more likely to see a report that the physician entered a peripheral vessel and manipulated the catheter into either the aorta or vena cava than that he placed the catheter directly into the aorta or vena cava. The direct translumbar approach is an exception and has its own access code, 36160 (Intro-duction of needle or intracatheter, aortic, translumbar).

You should use intra-arterial and intra-aortic codes 36200 and 36100-36160 to report nonselective arterial procedures, and use intravenous codes 36010 or 36005 for nonselective venous procedures.

2. Size up selective. For selective procedures, the physician:

• punctures an artery and manipulates the catheter into a different branch artery

•  punctures a vein and manipulates the catheter into a different vein

•  manipulates the catheter from the aorta into a branch artery or

•  manipulates the catheter from the vena cava into a branch vein.

Use 36215-36218 to report thoracic and brachiocephalic selective arterial procedures and 36245-36248 to report abdominal, pelvic, and leg selective arterial procedures. You should look to 36014-36015 for selective pulmonary artery catheterization codes.

You only have two codes to choose from for selective venous catheterizations:

36011 and 36012. 

3. Become a bookworm. Pick up some interventional Radiology Coding guides and work with the interventional radiologist to ensure he understands what information to include in dictated reports to assist you with coding and to substantiate your claims to payers.